梗阻性黄疸大鼠血浆和肾组织内皮素含量的变化及与肾功能关系的研究  

A study on changes of endothelin concentration in plasma and kidney tissue of rats with obstructive jaundice and relationship between endothelin and renal function

作　　者：柏楠[1] 蔺锡候[1] 王宇[2] 史争鸣[1] 

机构地区：[1]积水潭医院普外科,北京市100035 [2]北京友谊医院肝胆外科

出　　处：《中华肝胆外科杂志》2002年第4期228-231,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　了解血浆、肾组织内皮素 (ET)在梗阻性黄疸 (OJ)大鼠模型上不同梗阻时间的变化情况 ,探讨循环ET和肾内ET与梗阻性黄疸时肾功能损害的关系。方法　胆总管结扎及假手术组各 32只Wistar大鼠分别于术后 5 ,10 ,15 ,2 0d(每小组n =8)采用放射免疫法测定血浆和肾皮质、髓质组织匀浆ET含量 ,同时测定血清肌酐 (Cr)、尿素氮 (BUN)和直接胆红素 (DB)浓度 ,并对肾脏行光镜下病理形态学观察。结果　血浆ET浓度及肾皮质、髓质ET含量在梗阻 5d即升高 ,且随OJ时间延长进一步升高 ,伴有血清Cr、BUN、DB的升高和肾脏病理形态的进行性改变。血浆ET、肾皮质ET在大部分或部分时相与Cr、BUN呈明显正相关 ,血浆ET在大部分时相与DB呈明显正相关。结论　梗阻性黄疸时循环和肾内ET水平持续性升高 ;血浆和肾皮质ET的升高可能参与了肾脏滤过功能的损害 ;肾髓质ET的升高可能是导致OJ早期尿浓缩功能异常的介质之一 ;高胆红素血症可能是血浆ET升高的原因之一。Objective To study the changes of endothelin (ET) in plasma and kidney tissue of Wistar rats with obstructive jaundice (OJ) and investigate the relationship between ET and renal functional impairment in OJ. Methods By using specific radioimmunological method, the levels of plasma ET and kidney ET were measured in rats with common bile duct ligation (n=32) and those with sham operation (n=32) for 5, 10, 15 and 20 days after operation. Meanwhile, the levels of serum bilirubin (DB) and BUN and Cr were also determined in all the rats. Renal histological changes were observed with optical microscopy. Results The levels of ET in plasma and renal tissue as well as those of serum Cr, BUN and DB in all OJ subgroups were continually elevated. The levels of ET in plasma and renal cortex were closely related to serum Cr and BUN. Furthermore, the former was closely related to DB. Conclusions The elevated ET in plasma and renal cortex can lead to impairment of renal filtration function and that in the renal medulla might be one of the factors causing abnormality of renal concentration function in the early stage of OJ. Hyperbilirubinemia might be one of the causes leading to increase of plasma ET level.

关 键 词：梗阻性黄疸 内皮素 肾功能损害 

分 类 号：R657.43[医药卫生—外科学]